Agenda and minutes

The Chair welcomed everyone to the meeting and asked those present to introduce themselves.

The Chair will draw attention to the emergency evacuation procedure as set out under Note 5.

The Democratic Services Officer announced that apologies for absence had been received from Councillor Lesley Mansell, Councillor Alison Born, Councillor Paul May, Councillor Ann Morgan, Councillor Karen Walker and Suzanne Westhead (Director of Adult Social Care).

At this point in the meeting declarations of interest are received from Members in any of the agenda items under consideration at the meeting. Members are asked to indicate:

(a) The agenda item number in which they have an interest to declare.

(b) The nature of their interest.

(c) Whether their interest is a disclosable pecuniary interest or an other interest, (as defined in Part 4.4 Appendix B of the Code of Conduct and Rules for Registration of Interests)

Any Member who needs to clarify any matters relating to the declaration of interests is recommended to seek advice from the Council’s Monitoring Officeror a member of his staff before the meeting to expedite dealing with the item during the meeting.

The Chair announced that she intends to set up a group, consisting of Panel members, to look at Knife Crime involving Young People to see what work the Council and other agencies can do to address this issue.

She also informed the Panel that she would like them to consider whether a Young Person could become a representative on the Panel, especially for those meetings that will be focussed on Children’s Services.

There were none.

The Panel confirmed the minutes of the previous meeting as a true record and they were duly signed by the Chair.

The Cabinet Member(s) will update the Panel on any relevant issues. Panel members may ask questions on the update provided. The intention is that the update will be circulated to the Panel in the preceding week of the meeting.

The Assistant Director, Operations, Adult Social Care and the Assistant Director, Integrated Commissioning addressed the Panel and gave a presentation. A summary is set out below and a copy of the presentation will be attached as an online appendix to these minutes.

Adult Social Care - Our Local Story

Context for our families in Adult Social Care

•  We are all about our people - Population approx. 193,000 – 147,000 who are over the age of 18 

•  One of the least deprived authorities in the country, ranking 247 out of 326 English authorities. Despite this, pockets of high deprivation exist.

Our culture and ethos in Adult Social Care

•  Our vision for Adults is:- We all want to live in the place we call home with the people and things that we love, in communities where we look out for one another, doing the things that matter to us.

•  We have high aspirations for Adults who require social care support to remain living safely within their community network.

•  We are developing a strong Practice Framework based on what people need to remain in their communities to support them achieve the full potential.

•  An inspection of Adult Social Care by the Care Quality Commission is due at some point in the future.

The last 2 years…..

•  It has been a challenging 2 years for all Local Authorities and B&NES: Covid 19 has impacted our workforce, our adults who require support and our communities.

•  The financial climate has also been a challenge for Adult Social Care over this period, but we have balanced our money with underlying pressures.

•  There is significant political support for Adult Services – Our Leader, Lead member, Scrutiny Panel and wider cabinet actively support improved outcomes for B&NES Adults who required social care support.

Our starting point - the B&NES, Swindon & Wiltshire population

•  Population growth in all areas, with largest growth in B&NES.

•  Growth in frailty & dementia is below that of the >80 population due to long term improvements in health.

•  Despite Swindon >80 population being the lowest in absolute terms it has the greatest increase in frailty and dementia cohorts.

Adult social care population - Data for Feb 2022 – Jan 2023

•  2,284 – People supported by Adult Social Care

•  Age of people supported: 18 – 64 = 42% / 65 and over = 58%

•  Gender of people supported: Men = 44% / Women = 56%

Who Leads The Adult Social Care Team

•  Suzanne Westhead - Director of Adult Social Services

•  Ann Smith - Assistant Director of Operations

•  Natalia Lachkou - Assistant Director – Integrated Commissioning

•  Claire Thorogood - Assistant Director – Strategy, Transformation and Governance

Kevin Burnett commented that earlier in the year Councillor Alison Born had referred to some ongoing research with regard to Covid-19 and he asked if there was any update on this available currently.

The Director of Public Health replied  ...  view the full minutes text for item 8.

The Panel will receive an update from the B&NES, Swindon & Wiltshire Integrated Care Board (BSW ICB) on current issues. The intention is that the update will be circulated to the Panel in the preceding week of the meeting.

Laura Ambler, Place Director, B&NES, Swindon & Wiltshire Integrated Care Board addressed the Panel and highlighted areas from within the update report that had been circulated. A copy of the update will be attached as an online appendix to these minutes.

Integrated Community Based Care programme update

The Integrated Care System (ICS) has recently published its Integrated Care Strategy which describes the key priorities and ambitions for the ICS. An integral part of this is to increase the focus on prevention and early intervention, delivering this through the BSW Care Model and providing excellent community-based services for people in BSW.

This future model will enable better integration of local services to meet the needs of our communities, helping to address the challenges facing health and care services including increasing demand, workforce recruitment and retention, and financial sustainability.

The BSW Integrated Care Board (ICB) has established a programme of work called the Integrated Community Based Care Programme (ICBC) to lead the process of securing specific community services from 2025 onwards, working on behalf of the Councils and BSW ICB. The ICBC is governed by a programme board made up of representatives from BSW ICB and the BSW Councils.

The ICBC programme will start with ensuring the immediate continuity of service provision for the people of BSW and the workforce for the financial year 2024/25. This allows sufficient time to ensure people and communities, clinicians, professional staff and providers of services are involved as appropriate in the process.

Our plan for engaging with the public on this subject is in development and we will be in a position to offer an update on this over the coming months.

Royal United Hospital Urgent Treatment Centre

BSW ICB and the RUH have been reviewing the Urgent Treatment Centre (UTC) model of care delivered from the Royal United Hospital. Following feedback from patients and staff, we plan to amend the service provided in the UTC during the hours of 10pm-8am to respond to the needs of people presenting during this time from September 4^th  2023. This will not change access for our local population and aims to provide more rapid assessment and, in particular, advice, guidance and signposting for patients who may be more appropriately treated elsewhere or at different times.

The aim is to support more timely assessment and interventions for patients who do require urgent care support at the RUH. The new streaming pathways do not include children, young people and people with a learning disability and/or autism who will be seen in line with current arrangements.

We will be developing a communication plan over the next few weeks prior to this change to ensure people are aware of how the service will be delivered. We will be monitoring the change to understand any impacts.

Paul Boyle, Transformation Director, BSW Elective Care Programme addressed the Panel regarding the Sulis Hospital, Bath. He informed them that the hospital currently provides for approximately 50% private patient activity and 50% NHS activity and is seeking  ...  view the full minutes text for item 9.

This presentation is provided for the Panel by the Bath & North East Somerset, Swindon & Wiltshire Integrated Care Board.

Laura Ambler, Place Director, B&NES, Swindon & Wiltshire Integrated Care Board introduced this report to the Panel and highlighted the following areas from within it.

Integrated Care System - Purpose and functions

The purpose of ICSs is to bring partner organisations together to:

• Improve outcomes in population health and healthcare

• Tackle inequalities in outcomes, experience and access

• Enhance productivity and value for money

• Support broader social and economic development.

BSW Integrated Care System -  How the BSW ICS is made up

Integrated Care Alliances (ICA) x 3

• Place-based partnerships of NHS, councils, community and voluntary organisations, local people, carers

• Lead the design and delivery of integrated services at place

BSW Integrated Care Board (Statutory NHS organisation)

• Develops a plan for meeting the health needs of the population,

• Manages NHS budget

• Arranges for the provision of health services in BSW

BSW Integrated Care Partnership (Statutory committee)

·  Formed between the ICB and local authorities

•  A broad alliance of organisations concerned health and wellbeing of the population

• Author of the Integrated Care Strategy

• Advocate for innovation, new approaches and improvement

Local Authorities x 3

• Responsible for social care and public health functions and other services for local people and businesses.

She referred the Panel to page 34 and the ‘Integrated Care Strategy on a page’ with its three key objectives.

·  Focus on prevention and early intervention

·  Fairer health and wellbeing outcomes

·  Excellent health and care services

BSW Care Model

·  Personalised Care

·  Healthier Communities

·  Joined-up Local Teams

·  Local Specialist Services

·  Specialist Centres

If we are successful we will see long-term improvements:

·  An overall increase in life expectancy across our population

·  A reduction in the gap between life expectancy and healthy life expectancy across our population

·  Reduced variation in healthy life expectancy by geography, deprivation, ethnicity and other characteristics

B&NES ICA – Priority work areas and themes

Four key priorities that run across all of our themes

·  Workforce (or people and culture)

·  Improve population health and reduce health inequalities

·  Design and implement integrated neighbourhood teams

·  Redesign community services

The role of the B&NES Health and Wellbeing Board is to set the vision to improve health and reduce health inequalities within the B&NES population.

• The Health and Wellbeing Strategy (H&WBS) is based on meeting needs identified in the Joint Strategic Needs Assessment (JSNA), referred to locally as the Strategic Evidence Base.

• The H&WBS sets out the Board’s strategic direction for B&NES population level outcomes and four broad high-level priorities for system partners to operationalise.

• The H&WBS has an implementation plan which gives further detail on the actions that organisations will take place to address those priorities.

• There are three actions in this plan that are the responsibility of the ICA to lead on. They have been identified as actions that align particularly well with the role of the Board’s terms of reference, and that directly align with the ICA priorities and actions  ...  view the full minutes text for item 10.

This paper gives an update on the development of the Health and Wellbeing Strategy’s Implementation Plan and an explanation of the Better Care Fund Funding arrangements.

The Director of Public Health introduced this report to the Panel and highlighted the following sections from within it.

The B&NES Health and Wellbeing Strategy’s Implementation Plan

The B&NES Health and Wellbeing Strategy was approved by the Health and

Wellbeing Board in March 2023.

The Strategy has four key priorities:

(1) Ensure children and young people are healthy and ready for education

(2) Improve skills, good work and employment

(3) Strengthen compassionate and healthy communities

(4) Create health promoting places

Since the writing of the strategy a Strategy Implementation Plan has been written that sets out actions to be owned and delivered by partnerships and teams against the four priorities above. This Implementation Plan was approved by the Health and Wellbeing Board in June 2023.

The Implementation Plan was developed through extensive and iterative collaboration with individuals, teams and partnerships involving colleagues from the NHS, local VCSE groups and the Council, linking with existing strategies and working with current capacity.

Extensive effort has been made to ensure alignment between various strategies and implementation plans currently being developed or refreshed that impact on the health and wellbeing of the B&NES population.

A process by which implementation of the Strategy and its impact will be monitored, understood and reported back to the Board for discussion and assurance is in development and will be overseen by the Health and Wellbeing Strategy Steering Group. A proposal for this process will be brought to the Health & Wellbeing Board in September for agreement.

Better Care Fund arrangements

The Better Care Fund (BCF) is a coming together of funds and strategies for the ICB, Council and DHSE to create integrated planning, development and delivery in adult health and social care. The Fund has been in place since 2015 with a growing set of guidance and direction as to how funds should be deployed.

The Health and Wellbeing Board is the responsible and accountable body for the deployment, monitoring and impact of the BCF. It is expected that the outworking of the annual BCF narrative plan, that is submitted to DHSC, reflects the Health and Wellbeing Strategy and the priorities and interests set out by the Health and Wellbeing board and its constituent members in line with the guidance.

The Health and Wellbeing Board is expected to receive regular updates on the delivery and implementation of the BCF and to also annually agree the narrative plan setting out priorities and commitments.

The plan for 2023/5 was submitted to and approved by the Health and Wellbeing Board on 20 June 2023 and submitted to the national team on 28 June 2023.

Councillor Liz Hardman asked if the Better Care Fund was managed HCRG.

The Director of Public Health replied that it was not and that the fund is managed by the Local Authority.

The Chair referred to the governance of the Fund and that it was monitored by the Health & Wellbeing Board. She asked what opportunities there will be in the future to scrutinise any of  ...  view the full minutes text for item 11.

Adoption West (AW) started operating on 1 March 2019, as a Regional Adoption Agency (RAA) created by Bath and North East Somerset Council, Bristol City Council, Gloucestershire County Council, North Somerset Council, South Gloucestershire Council and Wiltshire Council as a response to the government’s plans, published in June 2015, to regionalise adoption services across England and Wales.

Adoption West is a local authority trading company which is owned by the six local authorities and commissioned by them to provide adoption services.  Adoption West is registered with Ofsted as a Voluntary Adoption Agency. The primary aim of this regionalisation was to deliver an adoption service which offer improved outcomes for both children and those who want to adopt.

The scrutiny panel (Adoption West Joint Scrutiny Panel) has been created to act as a critical friend, providing independent scrutiny of the work of AW and making constructive recommendations to ensure that AW meets its performance targets and expectations.

The scrutiny panel is an essential element of assuring democratic accountability for the use of public funds; although it does not fall under the banner of ‘Overview and Scrutiny’ as defined by the Local Government Act 2000 in that it is not a body jointly formed by the six participating councils. The scrutiny panel reports directly to the AW Board. The AW board monitors the efficiency of the scrutiny panel, including through the annual report, an example of which is attached for reference.

For information, Cllr Michelle O’Doherty represented B&NES on the Joint Panel during the life of the previous Council.

Decision required

The CAHW PDS Panel is requested to appoint a member to sit on the Adoption West Joint Panel to represent the organisation for the lifetime of this Council.

The Policy Development & Scrutiny Officer introduced this item to the Panel. He explained that the Children, Adults, Health & Wellbeing PDS Panel is requested to appoint a member to sit on the Adoption West Joint Panel to represent the organisation for the lifetime of this Council. He added that in the previous Council period this position had been taken up by Councillor Michelle O’Doherty.

The Chair proposed that the Panel reappoint Councillor O’Doherty.

Councillor O’Doherty replied that she would be happy to accept the role again on behalf of the Panel.

There were no further nominations and the Panel RESOLVED to agree that Councillor O’Doherty shall be their representative on the Adoption West Joint Panel.

This report presents the latest workplan for the Panel. Any suggestions for further items or amendments to the current programme will be logged and scheduled in consultation with the Panel’s Chair and supporting officers.

The Chair introduced this item to the Panel. She summarised some of the subjects that had been raised through the course of the meeting that the Panel would like to look at further in future meetings and asked for any other suggestions.

·  Knife Crime (Chair)

·  Young Carers (Chair)

·  Effects of Long Covid / Repeat infections in schools (Councillor Harding)

·  Homelessness – Health impacts (Councillor Crossley)

·  Care Homes (Chair)

·  Dental Services (Councillor Hardman)

·  Education matters – School buildings / Absences / Exam Results (Chris Batten)

·  Exploitation of Care Home Workers (Chair)

·  Exploitation of Children / Child Sexual Exploitation (Chris Batten)

·  Young People – Mental Health Support / Social Media use / Isolation (Kevin Burnett)

·  Culverhay site update (Chair)

·  Care Home – Qualitative research into deaths due to Covid (Chair)

The Panel RESOLVED to note the proposals that had been made for future reports.